INTRODUCTION: Danish healthcare seeks to improve cancer survival through improved diagnostics, rapid treatment and increased focus on cancer prevention and early help-seeking. In neuro-oncology, this has resulted in the Integrated Brain Cancer Pathway (IBCP). The paper explores how the pathway works in the initial phase in a clinical setting with emphasis on pathway criteria. MATERIAL AND METHODS: All patients admitted during the first two-year period to a regional neurology department in Denmark and fulfilling the IBCP inclusion criteria were included. Data regarding onset symptoms, diagnosis and time for diagnostic work-up were obtained and supplemented by a retrospective review of patient records. Sensitivities, specificities and positive predictive values of the inclusion criteria were calculated with magnetic resonance imaging scan of the cerebrum as index of validity. RESULTS: The strength of the pathway inclusion criteria was determined largely by the number of criteria fulfilled and by the type of predominant symptoms. The criteria identified the majority of patients with symptomatic brain malignancy and were also highly predictive of general structural brain lesions. CONCLUSION: The introduction of the pathway is a major step forward in the efforts to optimize brain cancer patients' illness trajectory. FUNDING: This study was funded by a grant from the Danish Ministry of Health and Interior Affairs 2009 and the Helen Rude Foundation and has been approved by the Danish Data Protection Agency. TRIAL REGISTRATION: not relevant.
INTRODUCTION: Danish healthcare seeks to improve cancer survival through improved diagnostics, rapid treatment and increased focus on cancer prevention and early help-seeking. In neuro-oncology, this has resulted in the Integrated Brain Cancer Pathway (IBCP). The paper explores how the pathway works in the initial phase in a clinical setting with emphasis on pathway criteria. MATERIAL AND METHODS: All patients admitted during the first two-year period to a regional neurology department in Denmark and fulfilling the IBCP inclusion criteria were included. Data regarding onset symptoms, diagnosis and time for diagnostic work-up were obtained and supplemented by a retrospective review of patient records. Sensitivities, specificities and positive predictive values of the inclusion criteria were calculated with magnetic resonance imaging scan of the cerebrum as index of validity. RESULTS: The strength of the pathway inclusion criteria was determined largely by the number of criteria fulfilled and by the type of predominant symptoms. The criteria identified the majority of patients with symptomatic brain malignancy and were also highly predictive of general structural brain lesions. CONCLUSION: The introduction of the pathway is a major step forward in the efforts to optimize brain cancerpatients' illness trajectory. FUNDING: This study was funded by a grant from the Danish Ministry of Health and Interior Affairs 2009 and the Helen Rude Foundation and has been approved by the Danish Data Protection Agency. TRIAL REGISTRATION: not relevant.
Authors: Robin Grant; Therese Dowswell; Eve Tomlinson; Paul M Brennan; Fiona M Walter; Yoav Ben-Shlomo; David William Hunt; Helen Bulbeck; Ashleigh Kernohan; Tomos Robinson; Theresa A Lawrie Journal: Cochrane Database Syst Rev Date: 2020-09-04